Healthcare Provider Details

I. General information

NPI: 1659147395
Provider Name (Legal Business Name): NORTHSTAR CARE GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2023
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12700 WITHER STEELE CT
CHARLOTTE NC
28273-5002
US

IV. Provider business mailing address

4800 EXPRESS DR # 19769
CHARLOTTE NC
28208-6354
US

V. Phone/Fax

Practice location:
  • Phone: 347-515-0171
  • Fax:
Mailing address:
  • Phone: 347-515-0171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name: TODD REID
Title or Position: MANAGING MEMBER
Credential:
Phone: 347-515-0171